Open access patients referred for colonoscopy will not have haemorrhoids treated during their procedure. There are a number of reasons for this. Firstly there are a number of treatments available for treating haemorrhoids (topical medical treatment, sclerotherapy, banding, haemorrhoidectomy), and what treatment is used varies according to the clinical situation and the wishes of the patient. In addition there are potential complications of haemorrhoidal treatments which have to be discussed with the patient prior to administering treatment. As the patient has not had this explained to them prior to the procedure, it is therefore not advisable or possible to administer treatments without having gone through this consent process first. Generally speaking most patients having haemorrhoids treated should be referred to colorectal surgeons so that the treatment options, and the risks and complications can be discussed first.